Module 4: An Introduction to the Principles of Critical Appraisal of Health Economic Evaluation Studies

Key areas for critical appraisal - 2. The assessment of resource use and cost

Two questions need to be addressed in relation to how the economic evaluation has assessed resource use and cost:

a) Are the main areas of resource use identified?b) Are the appropriate costs measured?

It is important to remember that costs here do not equate with expenditure. Economic cost, that is, opportunity costs are the benefits of opportunities forgone; i.e., the best possible use of the same resources .

2a) Are the main areas of resource use identified?

The main areas of resource use which may require specific identification and measurement of costs are:

Health care resources

Other related services

Clients and their families

Time lost from usual activity

This is not an exhaustive list but illustrates the main categories.

Examples of health care resources include (but are not limited to) staffing, consumables such as supplies and equipment, overheads such as heating, lighting, cleaning, laundry services etc., and capital such as land, buildings and major items of equipment.

Other related services costs include resources associated with community, ambulance and voluntary services. As with health care resources they may be categorized as staffing, consumables, overheads, and capital.

Resources used by clients and their families may take the form of inputs to treatment, e.g., informal care or expenses, such as transport costs.

Time lost from usual activity may take the form of time away from work, loss of leisure time, or unpaid work.